Intro

All content of this blog is my own opinion only. It does not represent the views of any organisation or association I may work for, or be associated with. Nothing within this blog should be considered as medical advice and you should always consult your Doctor.

Baby is using you as a dummy - it's just for comfort!

Perhaps the most frequently uttered words on parenting forums and groups worldwide and every time I just want to shout "yes a baby getting comfort from it's mother - perish the thought, quick ring a baby tamer - otherwise they will be breastfeeding at fifteen and co-sleeping into their twenties!"

Whatis the big problem in our culture with young infants being dependent on their mother? I know at the moment there are big social pressures to leave the baby ASAP and reclaim independence, but they are so teeny and dependent for such a short time. Believe it or not very quickly it's over and baby is busy exploring the world, too busy to want to spend hours with mum, and the time when mum can meet every need with just her body is gone forever. The breast meets every need a young baby has; hormones to help them sleep (yes this is why your baby want's to feed to sleep, yes it's normal, no they won't do it forever!) nourishment, immunological protection, warmth, security, the list goes on and on...

Non nutritive sucking (or "just for comfort") is the fluttery sucking that happens at the end of a breastfeed, when the rhythmic swallow pattern has ceased. It is hugely important to a baby on many levels: neurologically, psychologically and physically - so much so that if a baby is bottle feeding, they should have access to a clean finger or pacifier. But lets really look at what that is - it's an artificial nipple, a copy, a substitute for the real thing; even the name "dummy" tells you exactly what it is. When baby refuses it in favour of their mothers breast, the real thing, should we really be surprised? If someone wants to use a dummy, and is aware of all the implications (which I will come onto in a moment) - that's absolutely their choice, but we have gone far beyond that, to where a mother nurturing her infant is no longer desirable or even normal, instead the idea panics many - mum is told "bad habits" will form, or he will never sleep, or whatever other fantastic myth someone has decided to attribute to it - ah yes he was a late potty trainer, well that's because you breastfed on demand - rod for your own back.

It starts at birth, because babies biological instincts are such a contrast to what our society now deems acceptable, to our cultural norms. Human infants are only born with 25% of their developed brain; the other 75% develops afterbirth - experts believe this is due to increased brain size which has forced earlier delivery to enable baby to fit. Some now feel the first few months out of the womb, are actually a fourth stage of gestation - baby should still be attached to mum but externally. As a consequence of this immaturity, the human infant is forced to rely on external support, especially during the first 6-12 months of life (McKenna)They are programmed to be near mum, feed little and often, and frequently cry when they are put down away from her. To to combat this, instead of responding to baby (or "give in" as some claim), mums are told to give a "lovey" or comfort blanket so that baby can smell you when not with them, or take security in an item. I was once told this concept originated from orphans who had no mothers - I've no idea if it's true but really, is it healthy for a child to be securely attached to a piece of cloth rather than a human? doesn't matter if mum is here, as long as I have my lovey and we see children carrying these round at 4/5 years old! In cultures and social circles where mum keeps baby close and feeds on demand (not schedule feeding purely for nutrition) - having a security item is beyond rare. Has anyone studied the psychological impact outcome long term of "loveys"?

Perhaps some get wary as they see toddlers right through to school age children wandering round the supermarket, attempting speech through a plastic plug and think of the horror if they were expecting this from a breast. But the reality is that whereas pacifiers are habit forming, a baby gradually cuts down their feeding as they develop - sure some toddlers will have phases of manic feeding, often tied in with a big change such as starting nursery, house move or mum returning to work, it's still a big reassurance and comfort to them; but the big need to non nutritive suck diminishes dramatically after the first six months which ties in with introducing solids.

Comforting your baby with the breast and meeting all their needs will not make them clingy, dependent, unsociable, needy, non sleepers - or anything else that gets sold as a pitfall - this is what baby is born biologically expecting. In fact overwhelming evidence shows that the better we meet an infants needs, the more confident, independent and sociable the young child becomes. But if you think about it that makes perfect sense in terms of human nature - the more secure we feel, the more confident. Pushing independence and forced separation actually has the opposite result of making the recipient "cling on", searching for reassurance.

As mentioned above - the breast is the norm and the pacifier is the "intervention", and so with that comes the potential for risk; sucking is intended to be intricately linked with feeding - so separating the two is a significant shift. Studies have linked numerous issues with dummy use and whilst research can never prove something 100% when several studies begin to find the same outcome, it is of course worth considering in the decision making process. Some babies seem to take one with no obvious impact, whilst for others it can cause problems almost immediately. Level of use is also significant - using one for a short period when driving, or perhaps when sorting one twin and another needs to wait, can of course be helpful and unlikely to impact massively on many babies - especially once breastfeeding is established; but frequent use can create dummy addicts, rarely seen without one. I've even seen some mothers use them to make a baby stop babbling too loudly in public, or just because they had finished their bottle - despite baby being completely content; to me this is completely inappropriate.

1) SIDS - whilst some studies "appear" to show a reduced risk of SIDS when using a pacifier (although this research is definitely worthy of discussion!), others believe pacifiers increase the risk of SIDS by exerting abnormal pressures on the oral cavity, affecting the throat. The significant piece of SIDS research also showed stopping using a pacifier created the most significant risk - and how do parents guarantee a baby keeps on accepting one? I plan to discuss this more in another blog post as it has been requested on "Ask The Armadillo".

2) Changed oral development - adverse outcome has been strongly highlighted in relation to dentition, dental caries and malocclusion (Bowden, Paunio, Rautava & Sillanpaa, Karjalainen, Ronning, et al,Ollila, Niemela, et al, Gizani, Vinckier & Declerck). Extensive used has even been linked with changing oro-facial structure and long term issues such as sleep apnoea (although this risk is greater for non breastfed infants)

3) Reduced duration of breastfeeding - many studies have linked both early introduction of a bottle and pacifier use with shorter duration of breastfeeding. One found:

Pacifiers may be an effective weaning mechanism used by mothers who have explicit or implicit difficulties inbreastfeeding, but they are much less likely to affect infantswhose mothers are confident about nursing

Whilst another found increased risk regardless:

Among 249 children still breastfed at 1 month, the risk that a child would be weaned at any age between 1 and 24 months was higher in pacifier users than in non-users. The association remained even after adjustment for the child's age, sex, birth weight, socioeconomic status, and age at introduction of bottle-feeding.

I think how a pacifier is used may also influence this. If baby has breast for "food" and pacifier for "comfort" (ie the mum desperately trying to prevent bad habits), once his nutritional needs are met elsewhere, he is far more likely to wean and stick with his comfort item - these are the babies parents often claim "self weaned" long before the normal biological age. This ties in with another study that found the more times per day the pacifier was used, the higher the risk of early weaning.

4) Reduced time at the breast - In the early days, hunger is driven partly by a hormone called CCK - the same hormone that induces relaxation and sleep. After a feed baby has a high level of CCK, which tells him he’s full, but it drops again after another 10 or 20 minutes, so he thinks he’s hungry again. He may go through this loop several times, in what’s known as “cluster feeding,” before dropping into a solid, longer sleep. There is suggestion this system allows baby to fill their whole digestive system so excess hunger doesn't occur during a longer sleep spell. The key point is that sucking, not swallowing makes baby feel full and therefore pacifiers can cause babies to miss feeds which can impact further in the following ways:.

5) Reduced breastmilk supply - as feeding becomes established, the only indications mum's body gets about how much milk to make is how often baby feeds and how effectively they empty the breast. When introduced in the first few months pacifiers can cause infants to miss feeds, and prevent mum's body receiving the cues about how much milk to produce. As the most common reason for stopping breastfeeding is "insufficient milk supply" (whether perceived or actual) and most infants have a pacifier which may interfere with this mechanism.
6) Reduced weight gain - several studies have found regular pacifier use is associated with fewer feedings and reduced gain:

Findings indicated that the pacifier group breastfed approximately one less time per day and had a 15 to 30 minute shorter total suckling duration per day during the first 4 months of life than the group who did not use a pacifier. During the first 2 months of life, infants who used a pacifier had a mean of 0.5 feeds less per day and had 15 to 30 minute longer feeding intervals than infants who did not use a pacifier.

7) Reduced efficiency at the breast -

Sucking on an artificial nipple is different from sucking at the breast. The artificial nipple is already formed and fairly rigid. The breast is soft and flexible. The baby must open his mouth wide to latch on to the breast, and the nipple goes to the back of the mouth, away from the movement of the gums and tongue. A caregiver can coax a pacifier into a baby's closed mouth. The muscles of the mouth and face and the tongue move differently when sucking on an artificial nipple; the action used to drink from a bottle or to calm down with a pacifier won't get milk out of a breast.

Switching back and forth from breast to artificial nipple is a lot to ask of a baby in the early days of learning to breastfeed. A baby who tries to suck at the breast the way she sucks on a bottle nipple or a pacifier will quickly become frustrated and may cry, fuss, or refuse to nurse. She won't get much milk, and she may have a difficult time learning to breastfeed effectively. (LLLI)

8) Nipple confusion and soreness - the different technique required for a pacifier can cause -one study found babies were twice as likely to have breastfeeding problems as those who didn't have a pacifier (73% developed problems compared to 30% that did not)

9) Ear infections - several studies have found a connection, with one finding risk was doubled if the baby has the pacifier 5 or more times per day.

10) Increased risk of thrush - because the fungus that causes thrush thrives at room temp on moist surfaces a pacifier has the potential to increase rates of thrush. Several studies have found a greater incidence of candida, the fungus that causes thrush among babies who used a pacifier - the research suggested it may affect a baby’s ability to effectively clear sugar from his mouth. May also be linked with tooth decay - see here.

11) Increased risk of infections, including antibiotic resistant strains - One study found a wide range of disease-causing bacteria, fungus and mold on pacifiers that young children had been using. They added that pacifiers can often grow a slimy coating of bacteria called a biofilm, that actually alters the normal bacteria in a baby or toddler's mouth. That biofilm can spur inflammation and potentially increase the risk of developing gastrointestinal problems such as colic or even ear infections.

In fact, the same types of bacteria found on a common pacifier have been linked to cardiovascular disease, metabolic syndrome, allergies, asthma and autoimmune diseases, said study author Dr. Tom Glass, a professor of forensic sciences, pathology and dental medicine at Oklahoma State University.

The researchers cultured 40 different species of bacteria from the 10 used pacifiers. One pacifier was contaminated with four different strains of Staphylococcus aureus. What was particularly concerning, said Glass, was that many of the bacteria growing from the used pacifiers were resistant to commonly used antibiotics such as penicillin and methicillin. (1)

12) Habit forming - some infants use their pacifier as their comfort item, and thus are not keen to be parted with it! Resulting in prolonged dependency (the opposite of it's original aim then!) on an item and less autonomy. In older babies it can hinder babbling, resulting in delayed speech and can discourage toddlers from chatting, which they need to do to develop their language skills(The National Literacy Trust).

13) Reduced sleep - some babies very quickly will start to wake when they hit a light sleep cycle and don't have their pacifier (it falls out earlier during the deep sleep phase), not fun trying to locate and give back to baby numerous times per night!

14) Different brain patterns - A study examined whether nursing influences brain activity in the newborn and whether there are differences in this respect between breast and pacifier sucking. They noted the amplitude of the EEG increased significantly during breast-feeding in the posterior cortical areas in both hemispheres with a slight predominance on the right. Pacifier sucking had no significant effects on EEG activity.

Conclusion: Nursing effects a change in the brain activity of the newborn. The cortical response to nursing is most probably a result of activation of the neurohumoral mechanisms related to hunger and satisfaction, including the hypothalamic, limbic, and other brain stem structures, which also regulate the sleep-wake cycle and modulate the level of cortical activity with respect to attention and vigilance. (J Pediatr 1998;132:646-51.)

So next time you tell a mum to "knock that on the head - he's only using you as a dummy", remember - the reality is baby uses the dummy as a breast, sometimes with consequences. Ultimately finding out WHY baby has such an intense sucking need they need to suck excessively outside of feeding is probably more helpful. In taking air, disturbed gut flora (antibiotics, vaccines etc) tongue tie etc can all cause gastric discomfort eased by sucking.

64 comments:

FANTASTIC! Loved reading EVERY word of that.Made me question my own practices with my daughter, she was my first and I was pretty naive at the time. 19 months on and my son just would not take a dummy, THANK GOD is all I can say. :) I've been told to 'give him a dummy' and because he won't take one I don't :) Wish I knew the same with my daughter. Why don't HCP's do some research and re-educate themselves for the sake of the millions of babies they see over the year!

I absolutely adore my son and will make any sacrifice to make him as happy, healthy and secure as he can be. I am breastfeeding him and intend to continue for the foreseeable (currently 11 months). I currently have the issue that the baby wakes on average 20 times per night - I feed him every time & have heard this 'he's using you as a dummy' comment a lot. As I mentioned before I don't have an issue with making sacrifices, however now having not slept for more than 30 minutes in one go for over six months I'd like to know your thoughts on a solution as to be honest it has become a problem (not enough time, patience or energy for my first son, relationship on the edge and have nearly crashed the car with both kids in it, twice). I know he is just looking for comfort - but I am starting to wonder at what cost? Any advice welcome.

Co-sleeping is great! My guy is getting to the point where he can find me and latch on his own. Sometimes I wake up to his rooting and help him latch and then doze. He falls asleep within 10 minutes or so and we sleep together like this on and off all night save for a few diaper changes!

Hi AnonDo you mean in the last 6 months your baby hasn't slept more than 30 minutes straight?! if so how is his health/development? surely he must also be shattered?I guess the suggestion also is that if you didn't feed him when he woke, he wouldn't wake?FWIW I DIDN'T feed my first every time she woke, which was a lot (purely because I started off believing most mainstream stuff!)- although not 20 times per night for the most part. I was focussed on "bad habits" not letting her become reliant on things for sleep etc etc - so we had lots of waking, and as I didn't feed her to sleep that meant LONG awake stretches during the night ie awake from 11pm - 2am and suchlike (she wouldn't take a pacifier!) Even when I tried feeding to sleep she would feed then want to bounce around playing! plus frequent wakings and 5am starts.My second I fed at every peep and he was an amazing sleeper.Totally anecdotal but my point is some babies do have a harder time with sleep than others - it's not something you have done.If you want to drop me an email - have lots more questions as LOADS of things can impact on sleep patterns as I discovered when my first was over 2! lolAA

As always, what a brilliant article. I now live in Spain where babies appear to be born with a dummy! I haven´t ever seen any babies without one. When my first was born I kept been asked "hasn´t he got a dummy?". One of my aunts gave him one as his Xmas present. It was funny as he very kindly demonstrated to her how much he disliked them but spitting it out the minute she put it in his mouth (I was very proud of him). By the time I had my 3rd I had my very well practiced sentence "they´re not born with it you know...".

Here there are loads of children who still have one at the age of 3, 4 and even 5. I find it quite frankly disgusting and, needless to say, the great majority have problems with their front teeth.

Thank you AA! I feel confident in trusting my instincts not to give my daughter a dummy, but it's great to have the info to back up what I feel.

I didn't experience any pressure to give her a dummy until she was 12 months old and went on a 30 hour nursing strike when she developed a fever after a vaccination, and was teething too. I had to take her to see the out of hours doctor who told me ever so confidently that it would useful for her to be accustomed to a dummy and bottle to comfort and nourish her when she refused the breast. I think he sensed my scepticism as he went on to tell me he had kids so knew what was what. But how on earth do you get a distressed baby to take a dummy when she won't even but her mouth to her mother's beloved breast?

Needless to say I dismissed everything the doctor told me, but incidents like that do have a way or worming their way into your brain, and resurface in times of distress and doubt.

My daughter is now 18 months old, still breastfeeding, is happy, confident, and shows no interest in having a soother or lovey.

Hi BecI was REALLY naive as a new mum lol so BTDT! My first had a dummy from a couple of months to around 4 months, when she lobbed it and refused to have it again. Luckily my DD didn't go for mainstream parenting ideas lol, which forced me to take a look at the evidence...before that I thought all babies had a dummy :| (which technically most do!)

Hi BeccaStunned at your doctors advice - I wonder if baby refuses a bottle, they suggest relactating so you have a backup during those times ;)Good on you for dismissing the doctor and following your instincts - it's hard though and I hear of so many mums who totally believe some absolute corkers, and they are absolute because "the doctor told me". I've been asked to deliver some training to GP's in the past because they get no training in this area as standard - yet mothers of course seek their advice. Mastitis is a common one - the number who get antibiotics for non infectious mastitis (and thus they're not only pointless but wipe out mums good bactiera for nothing)

as a mother who breastfed/feeds on demand, carries my babies close to my heart and endeavors to nourish their little hearts, bodies, minds and souls the best i can, i have actually felt far more pressure to not use a dummy than to use one :( i use dummies with both my children for different reasons, though not as a replacement for suckling on my breast and certainly never to cease them from babbling! I bf'd my first child to sleep until she was 18 months and would have happily continued. We now face the need to phase out it's use with our 2 yo which we will do with love and care, however i dont believe it has effected my daughters sleep, health, speech, sense of security or confidence but as with all things this will differ depending on the individual and their circumstances.i hope whatever our parenting choices are, that as mothers, we can be nurturing to one another and respectful of our differences.i do think it’s important to make informed decisions as parents, so thank you for writing this article, it can be hard to find research on the subject.

QUOTE i dont believe it has effected my daughters sleep, health, speech, sense of security or confidence but as with all things this will differ depending on the individual and their circumstances.

Absolutely, my daughter had one only for a short time as per my other reply and did get oral thrush - my son was premature and in the very early days had one for a short period after a feed because his reflux was so bad due to immature tummy muscles, he wasn't gaining weight as he would projectile vomit his entire feed! yet he never had thrush..so they DO have their uses!

For me the first child I used one because I just thought that's what everyone did and was terrified of a "habit" where my child would be constantly attached! The second time the risks of him continuing to not gain weight, were greater than the risks of very short term use of a pacifier for half an hour after a feed - where he did also comfort suck. It wasn't offered at other times as I had to balance it with ensuring no feeds were missed in favour of it!

So it's absolutely about how you use one as well as if you use one.

But, what worries me is at the moment there is a fear of comforting your baby with the breast - bad habits will form! I even read the other day that mum shouldn't feed baby every time she cried - otherwise she will learn to cry to be fed (but seemingly crying for a plastic nipple is just fine!) I'm still baffled as to what on earth the mum actually meant! don't let your baby realise her needs will be met!? as though she has another way to let you know instead of crying :S Health professionals warn mums of the risk of letting baby use them as a pacifier - so mum uses a paci then has a toddler she has to try and wean from it, that habit seems to be ok...

Thanks for the great post! I have written about this before too, but not with all of the great detail you have! Here, we call them "pacifiers", and it is common to hear a mom complain that her baby is using her as a "human pacifier". I have always thought that was such a ridiculous concept - as though the rubber one was the original and the breast was the substitute!

@Anon: "...having not slept for more than 30 minutes in one go for over six months I'd like to know your thoughts on a solution as to be honest it has become a problem..."

My son at 4 months suddenly began waking every 20 minutes and fussing/wriggling and it wasn't until a week later (and little to no sleep for me!) that I realized it was because our mattress was uncomfortable for him. I had tried another bed with him and he slept soundly, only waking twice to feed. I believe children, and especially infants, show through their behaviour what they may need since they cannot vocalise it yet. They never do anything for nothing. Perhaps you just haven't figured out yet why your child is being fussy yet but putting on a band-aid (using a pacifier)won't fix their original issue.

Perhaps they are uncomfortable with their sleeping arrangements (do you co-sleep or use a crib? This can make all the difference); do they maybe have gas after feeding and need to burp or maybe relieve themselves? (my son would wake up and fuss when he needed to burp or pee); perhaps their pj is uncomfortable or their bed is; or perhaps it's even a form of anxiety if you tend to leave them alone in another room when they fall asleep and now are afraid of sleeping deeply and waking up alone.

There is a reason, a valid one, for why your child is doing what they're doing. The trick is finding out why exactly. Ah, the joys of parenthood!

This is nice to read :)I feel like a human dummy with my lo, but I keep telling myself it won't be for long! I have tried a dummy in desperation, so I could eat or shower occasionally, and she didn't like it. I was told to try others, it can take a while to find one she likes... But she has one she likes, it just happens to be attached to me. Which means she is constantly attached to me, which seems to me to be what she wants/needs. A dummy isn't natural, my breast however is.And now as she has got older, and slightly less needy, we get around the eating and shower issue, without the need for a dummy. It just took time, patience and learning.

It has meant I have "sacrificed" alot of myself to her, but I don't feel that way. Too many people seem to see babies as an inconvenience, that need to be slotted into our time frame asap. This doesn't seem to be what she wants, what she wants is me, when she needs comfort or nutrition, and I feel like I am giving her my best by giving her the breast when she needs it and not plugging her up with something to placate her. She is so dependent and can do nothing for herself.I would be fairly upset if I went to get something to eat, a drink, a hug, some human interaction and instead was offered a dummy to suck on.

Loved the article! One of my littlies was miss independent from day one, the other very demanding, needing much more time at the breast, so much so that she would vomit (really vomit - projecting 1.5 metres, not just possitting). The only way to stop this was to give her a dummy too, and carry her around so that she didn't cry.

I think it does come down to individual babies too. Because Miss M is so much like me as a baby, and was so independent and didn't need constant cuddling, just needed to be in the same room as me, but I allowed her 1 hour on the breast each feed for a very long time, eventually reducing it to 40 minutes a feed. Obviously some of that would have been comfort. She also had to be in the same room as us, or within eye sight (but she has amazing eyesight). She also settled to sleep so easily, and never cried. I thought it was cute when she cried, because it was just so rare. I could put her down in the middle of the floor of an ABA meeting, and because it was bedtime and she'd just had a feed, she'd drift off to sleep. I weaned her at 18 months when we were having difficulties conceiving baby #2. I had initially wanted to tandem feed.

Miss C (baby #2) cried and cried and cried for 5 months. (Mum tells me my sister did the same when she was a baby.) She is still very vocal, very mummy orientated and affectionate. Such different children! She is also still feeding at 21 months. Perhaps she cried because her eyesight is poor and when I put her down it was hard to tell where I was. Not sure. Indeed after she got her glasses at 19 months things improved dramatically.

I have stopped the dummy with her at about 20 months, as I saw her becoming more and more headstrong as 2 approached (although she's been a tantrum thrower since 9 months) and her memory was improving so much that she could tell me where she left it last (very advanced speech for her age). I never let her have a dummy to sleep when she was exclusively breastfed. It was only so I could get dinner on etc. during the day. At night it was always the real thing. She has always been a phenomenal sleeper at night, and any waking is only a little cry for under a minute (and makes me wonder what she's dreaming about) and then it's back to sleep. Both girls have always slept in their own rooms. Both have been good sleepers from 6 weeks on, waking only once or twice during the night, but both cluster-feeding at dinner time.

Anyway, our dummy use was not the end of the world. I dislike dummies, and it was with mixed emotion that I saw it go, but I knew the time was right. As for breastfeeding, we're aiming for 2, and see what happens then. She still wants feeding 2 or 3 times a day (upon waking, before lunchtime sleep & before bed at night), and for now that's not too demanding.

I have always believed that littlies will sleep best on a full tum tum. So what's wrong with feeding just before bed? I always put them to sleep when they were dosy, not totally asleep and it worked so well... they slept very well. This Feed Play Sleep that we're all fed "lest the baby become dependent on mummy milk" is garbage.

My daughter is nearly 18mnths, still bf on demand although she doesn't 'demand' as often as she did. We don't co sleep because my husband has very valid concerns with it but she slept in our room untill she was 7 months old when necessity meant she had to move to the big cot in her room. Although she does not sleep particularly well, at least not reliably I would say she slept ok. BUT! I have always put a tshirt of mine in the cot with her following the advice of my very lovely midwife and she recently started carrying it around as a cuddly, including when she is bf. I felt that this was a phase and didn't want to interfere with it, she will happily discard if something more interesting comes along but wants it again when she is tired or upset, after reading your article, which was very interesting as always, I have concerns over her long term dependency. Am I just being overly sensitive? She seems to be a happy and well balanced child, or should I have concerns if it goes on too long? And how long is too long? Thank you. :)

Hi EmmaNightimes are when baby often seeks security - whilst it's VERY normal in our culture for infants to have their own rooms at 6 months (ie the SIDS risk drops so fine to move them now) this doesn't take into account any of baby's other needs besides not suffering SIDS. I don't want to sound at all judgemental in any of this as I did absolutely the same with my first and ended up co-sleeping on and off from around 18 months+ when I decided sleep was more important lol. Norms of society are deeply ingrained as Margot Sutherland discusses here: http://www.timesonline.co.uk/tol/news/uk/article1083020.ece

Your daughter seems to have taken the shirt as her security item, something she can take comfort in when tired/upset and when breastfeeding - because it has brought her comfort and security in the past. Removing it at this stage may naturally cause distress and I'm honestly not sure what is "too long" or the best thing to do at this point.

I do however have someone highly qualified in mind I may be able to ask about this if you wanted?

Dear AA. If that is ok with you then yes that would be very helpful. Thank you :) Flora was moved out of our room when she all of a sudden stood up in her crib :) her big cot just wouldn't fit in the room. The more I learn about what is best for babies the more I wished we'd co slept but my husband is really worried about it in case he squashes her and the couple of times we've tried it nobody got a good nights sleep. I need to find another solution. Thank you for your help. :)

Yes when we tried co-sleeping when my DD was younger it didn't work too well - I think random co-sleeping everything is different to when you just do it from day one (if that makes any sense? LOL) you're hyper aware of baby there, they pick up on this and also the different of being next to someone. Even though my DD was a lot older and I didn't worry about rolling on her the same it took a good few nights to all get used to it.

I wouldn't put a baby next to my DP either, with the best intentions he has flailing arms lol but safe co-sleeping is baby just next to mum - with either a bed guard or crib/cot attached known as side car sleeping.

Oh the things we breastfeeding mums have to listen to!I have 3 sons, whom I have fed to sleep, resettled with the breast every time they woke, and never used a dummy. I have recieved alot of sarcastic comments for my choices, but continued the same each time, if my baby wakes every hour, then he feeds every hour. So what? Who does it hurt? Better that the them relying on a dummy. I know plenty of mums who still give their 3-4yr old children dummies yet question me because I still breastfed my son at 2.5yrs. Surly breastfeeding is healthier then a dummy? LOLAnyway, Thanks for the great article!!

This has made me feel so much better. My daughter is 15 months and loves the breast. I have so many people make comments about me being a dummy. These comments make you question what you are doing but after reading this I know what I'm doing is right and best for my daughter

Yes leap quite! I've seen pictures of several celeb events where toddlers of 3/4 yr old have both bottles of milk and pacifiers, but the "original" version at a similar age would no doubt be the focus of the article, not something captured in the background.

Anon - definitely! also when you look at what's in breastmilk (as per the post I made a few days ago) what is the cost of depriving babes and giving them a copy?

useful to read this again as I've reached a bit of crisis point at 6 months and increasingly frequent night wakings (and baby wants to sleep facing and touching me - she doesn't as such comfort feed but won't sleep if I'm in any other position than facing her, which is a shame because I'm a back sleeper). At 6 months I am worried about creating a "bad habit" and it would be nice to have at least one 3 hour stretch of sleep a night, rather than the hourly wakings we currently have. I don't mind the night wakings too much though, but the unnatural sleep position which does my back in.

It appears this article is about as narrow minded and dummy hating as those idiots who say hes using you as a dummy. All 3 of my children have used dummys and continued to breast feed effectively and gained a massive amount of weight on solely breast milk.They are rarely ill, never had thrush or any of the other pap involved in this article. I was hoping i would find some kinship in open minded forums but instead i have found this as judgemental as most websites. This article has made me feel ineffective as a mother and a woman and made me worry about the choice i made which i didnt expect from this kinda of forum. Instead of being obsesive over forcing woman to shove the baby on the breast for everything maybe you should be pro whatever works for any mother and child and as individual as each mother baby bond.

Hi Mama BeanI'm sorry you found the article judgemental - one of mine had a pacifier so that's certainly not my stance :)

The point of the article is two fold; firstly it's normal for the breast to BE the pacifier - as per the opening, this is something many fail to acknowledge, demonstrated by the wording "baby is using you as a dummy". He's not, he's doing what's normal.

Secondly I support informed choice. The things listed are potential risks. It does not state ALL infants will suffer "this pap" as you call it. It highlights the risks scientific evidence has linked with pacifiers so the parents can weigh up the pros and cons and make a decision they are happy with.

If you are pro whatever works for each child - does that mean we simply don't mention the risks? Does it "working" negate the risk? For a mum who is undecided articles such as this can add information they didn't previously have, and I have received a lot of feedback this article has reassured people their baby IS normal and that they don't need to use a pacifier if they don't want!

If reading potential risks of pacifiers makes you worry over your choice - one has to wonder whether you yourself made an informed choice (and that's not to say it wasn't the right choice for you, which is a different matter entirely) perhaps to prevent other mums feeling concerned when they stumble upon such articles - promoting informed choice before making the decision should be something you support rather than kick the messenger over?

I like this alot! I CONSTANTLY (ok, yes that may be a slight over statement lol) get told that I'm making a rod for my own back and that its unhealthy to meet my daughters ever demand (sure, if she was 3, but she is only 5months! lol). I've... been told that every child needs a 'cuddler' too. So far I just follow my instincts that tell me she was inside me for longer than she's been in this world so its natural that she'll want to be attached! I have a lovely content, happy little girl and I firmly believe that this is due to meeting her needs day and night. I allow her to guide me (except when I'm driving ;)) and have learnt more from her than I ever thought possible! I love your intelligently wrote, well informed articles! They either teach me, inform me or validate my choices! Thanks AA!

I was told by a midwife after the birth of my first not to let my baby just suck for comfort and how to recognise those fluttery comfort sucks. I dutifully analysed every suck and removed comfort seeking baby to wails of distress. In my new-mother sleep deprived naivety I posted my dilema on an internet forum "my baby keeps comfort sucking, he's using me as a dummy, but when I try to stop him he screams". The numerous replies of "let him" were a revelation and this time around every time my baby squeaks she's on my boob, so much less stressful (for us both).

A mother at a group today asked me if my baby was any less clingy yet - my baby is four months old!

I'm sure I'll get told off for this, but #1 refused a dummy and is still a voracious feeder at 3+. Still wants regular day/night feeds.

Thankfully #2 does take a dummy (6 months).

If this helps him learn to self settle and means duration of BF is reduced, I can cope with it! WRT reduced weight gain/supply - well I'm tandem feeding and the baby remains very hefty, so I reckon I'm safe on that one.

I'm not entirely sure that generally no dummy = demanding, long term night and day breastfeeding versus dummy = self settling; if this is the general implication. Whilst it might be the case for you (at the moment) it's certainly not for all. I know numerous shattered mothers who are frequently woken to plug the pacifier back in, and numerous non dummy infants who sleep great and dropped their own nightfeeds :)

This is very interesting. I conformed to the "norm" with #1 and gave her a dummy and taggie and she had a pooh bear. This resulted in Granddad once driving the pooh bear to our house at night as we had forgotten him! With #2 I instinctivly knew that if baby wanted to suckle it was for a purpose and she has no dummy and the only thing she strokes whilst feeding is my arm! I also got a wrap sling carrier. Once I accepted that my baby needed me, my body, for the 1st year it was liberating! Its only a year and then they only want you when they are ill or tired!! I think most stress and depression associated with becoming a mother is due to the counter-intuitive expectations of society. We are supposed to "get our lives back" (and our figures but that is a whole other debate!)as soon as poss. Well they can all bog off!! My babies are my life and they make it brilliant!! No amount of holidays or nights out could compare to nurturing your little being with all your heart and soul!

Yet again you have sifted through the research and highlighted the conclusions that now seem painfully obvious. You have a real talent for making the data accessible to the layman and presenting it in an easy-to-understand way.

Your paragraph on 'lovey' blankets especially hit home with me. It's something I'd never considered before but my mother left my father when I was 2 and I went to live with my grandparents in a different country. I had my own blankets which I could not be parted with until I was around 14! I never realised that the two could be connected but now I think about it makes perfect sense - it was stability and comfort and was most definitely habit forming (I even hated them being washed as they'd smell 'wrong')!

As you say, it was the comfort and stability that I should have been getting from a mother that had been transferred to a piece of cloth.

You've certainly switched on a lightbulb in my head as it makes perfect sense and I'd always wondered why I was attached to them for so long.

It's good to know that when my youngest uses me as a dummy (who's the dummy now eh?) that it's not as heinous a crime as it is often made out to be; the time she will do it is short and nothing quite compares to seeing your baby snoozing next to you in bed and knowing that your body not only created and grew them but is keeping them alive and thriving even now ♥

Yet again, another absolute gem of an article. What a great resource for new mums this blog is! When my little ones were babies there seemed to be a constant conflict between my instincts and almost every other source of advice I came across. I think most of the time my instincts won out but I remember feeling guilty on occassions where they was an obvious confict such as when I let my baby suckle himself to sleep. Such a shame I felt guilty when I was simply going with my instincts and comforting my baby in the way that suited us both best! It's about time we stopped trying to fight against our instincts for birthing and caring for our children; I believe we have them for a reason and the more we trust in them the happier family life can become.

QUOTE i'm lucky both my little ones are thumb suckers so no need for boobie except for feeds and no looking for lost dummies. Everyone is different and unique and one solution wont fix all ;)

Yes if infants are only offered the breast as food, they will often seek their thumb/fingers if they're not offered a pacifier. As discussed the need to suck non nutritively is primal - but there are no antibodies, HAMLET, stem cells etc to be found in ones own thumb, but similar risks of malocclusion, palate deformation as with the paci.AA

I was never "used as a dummy" but I will now look at the expression in a different way. So I guess in that way your article did its job.However, somewhere along the way I stopped reading because it was making me feel very guilty for letting my 8month old use the dummy. Before I had her, I never thought I'd even buy the thing. My instincts were saying it was not necessary (and that's the impression I had from "the experts"). Then I had my girl and it was all different.In the early days it was because I did need to sleep sometimes. I thought if she sleeps between feeds with the dummy and I sleep between feeds at least at night, she'll grow better and I'll be able to look after her better (including better milk supply).Later on I tried to look up information on how to get rid of it without stressing her and us too much but "the experts" were just saying it's the hardest habit to break, they did not say how to break it.Apparently the best time to do it is around 16 weeks of age. Our circumstances at that time were not right (moving, travelling, etc).Then we had a couple of months of frequent waking but when she learnt to find the dummy herself, we were back to one wake a night (for a feed).I have friends who feed to sleep their 11m olds and wake frequently - for many months now. They are depressed, exhausted, stressed, have no break ever as they are the only ones who can look after the baby at all times and they wish their babies took the dummy. They have no energy to look after them during the day and I don't see how this "sacrifice" is a good thing for the child.I guess my point is that if you child refuses the dummy, then there is no question (and many parents of dummy dependant children will say good for you). If she takes the dummy and it's a positive thing for you, do not let anyone else make you feel bad for it.There will always be "experts" and "scientific research" who will suggest something is bad for the child and there will always be the same number of them suggesting it's not bad for the child at all.So maybe...apart from mentioning risks with dummies, the article could also mention risks of feeding (or letting the baby suck for comfort) every hour at night for months on end (not talking about a newborn here). Frankly, if a mum has trouble driving because she is too exhausted, that's a bigger problem than dental bills, isn't it?So for now, my baby will have the dummy for her sleeps until we can reason with her and then we'll send the dummy to the dummy tree or to another new baby or some other excuse and then we'll reward her for being a big girl. OR that's the plan anyway :) We'll see how we go.

QUOTE In the early days it was because I did need to sleep sometimes. I thought if she sleeps between feeds with the dummy and I sleep between feeds at least at night, she'll grow better and I'll be able to look after her better (including better milk supply).

Of course you need to sleep sometimes, just as baby does - do you mean she wasn't sleeping ever?

QUOTE I have friends who feed to sleep their 11m olds and wake frequently - for many months now. They are depressed, exhausted, stressed, have no break ever as they are the only ones who can look after the baby at all times and they wish their babies took the dummy. END

and I have LOTS of "friends" who feed their infants to sleep and they don't wake frequently. AND I have lots of friends who don't feed to sleep and has a baby that never sleeps. If a child is waking frequently ime there is a reason for it.

My first didn't feed to sleep - yet she woke, I was tired/exhausted etc, ironically I probably wouldn't have been had I followed my instincts and fed her instead of believing it was the cause of her waking.

QUOTE If she takes the dummy and it's a positive thing for you, do not let anyone else make you feel bad for it. END

I absolutely agree nobody CAN make someone else feed bad about something, because only we own our emotions right? A list of risks of pacifiers will evoke different feelings depending upon who is reading it - am I responsible for causing them all?! I'm not sure I agree that a positive thing for one person equates to therefore there are no risks to the recipient - but I absolutely agree it's about balance and each parent making their own choices.

Rewarding her for being a big girl is a whole nother blog post in itself lol, but we'll save that for another day ;)

I'm chuffed to bits my formerly tongue tied boy won't take a dummy, even though we tried to get him to take one to give me a break before it was snipped. He won't always want me for comfort, and so what if I have to feed him 3-8 times a night to get him to sleep? I like the snuggles and the mummy milkies are good for his brain. :)

The bottom line is that dummies (pacifiers here in the US) are a substitute for mother's breast. Not vice-versa! There might be times when mother's breast is unavailable and a pacifier could be a helpful tool, e.g., mom is driving and baby is fussy in the backseat, or baby is in NICU and is being NG-tube fed and needs help getting settled/organized in the chaotic hospital environment. And yes, some babies cannot comfort themselves at the breast in the early weeks because of things like mom's OAMER--they feed, but then baby still has unmet sucking needs. These are the exceptions to the general rule, though.

Most of the time people seem to use pacifiers as a means to put off feeds, to avoid nursing in public, to avoid nursing at night. It may be a parent's free choice to do these things, but they are not without consequences, as AA lays out, and informed choices are always better choices, whatever the parent ultimately chooses.

I love this post. I hear the "using me as a dummy" line a lot and it makes me so sad. I thank you for putting the points and research so succinctly. As Dr Sears says "The time in your arms, at your breasts, and in your bed is such a relatively short while, but your message of love and availability lasts a lifetime".

I would love to hear your thoughts on this. My daughter goes through a colic-y period most night where she is full and windy and fusses at the breast for well over an hour if left to it. Most nights after a tummy rub and some winding, if she still is fussing I will give her a dummy for ten minutes or so. She usually calms down and either falls asleep and it falls out in those ten minutes, or calms down and stays awake, in which case after 10-15 minutes I take it out and she's calm enough to nurse herself to sleep. Is this likely to cause her problems down the line?

Hiya - I would wonder if there is an underlying reason why she is fussy/windy, yes the pacifier eases but is this treating the root cause or the symptoms? So the question isn't really whether the pacifier will cause problems down the line but whether any potential problems masked by the paci may?What do you think 10-15 minutes of paci sucking offers that a breast doesn't? (apart from a shallow tongue thrusting suck?)What's the big picture, how old is baby, what is output/weight like, how are feeds and sleep during day?AA

My wife has struggled with exactly this. As a first time mother she has struggled with society's counter-intuitive pressures that tell her she should be giving our baby tough love at every turn for her own good.Well stuff society and it's dysfunctional ideology! I am so pleased to have found this article and the comments from so many other people who beleive that listening to your instincts and not withholding love and contact from your baby is as right as it feels. I support my wife and all those mothers out there who don't care what others think about their mothering practices!

My little boy had had a dummy since almost day 1 and while at times it was a sanity saver when he was tiny i also wish he'd never had it. He's now 7 months and Up until 6 weeks ago he was only waking once a night to feed and otherwise sleeping through for 10 hours + but lately he wakes 3-4 times a night to feed and another few times wanting his dummy back which had before exhausting. I'm determined to continue feeding him (and definitely ignoring the people telling me to stop baby led weaning and fill him full of baby rice!) But would love to get rid of the dummy if possible. He's also still swaddled most nights, I'm not convinced he necessarily needs to be but he wakes without it as he pulls the dummy out if his mouth in light sleep! Any suggestions of gentle ways to help him sleep without dummy or swaddle would be much appreciated, I've lost count of the times I've been told to cio!

My baby is 10 months old and is exclusively breastfed. She co-sleeps and wakes between 4-5 times a night to nurse back to sleep. She is not feeding. It's just comfort suckling. I want to move her into her own room and I don't know how to help her self-soothe. Do you have any suggestions?

I use a dummy with my son. I wasn't going to. I was also going to breastfeed. My Mum was a bf counsellor in the 70s and had bf both my sisters and I. I never expected not to bf. My son was born a 36 weeks, after I planned a home birth after PREM I had a long and difficult birth with intervention. My son was jaundiced, had undiagnosed tt, no rooting reflex, no interest in bf or feeding at all. Had tt snipped at 5 weeks, then cranial osteopathy. Used a range of teats including Medela Calma to encourage bf action. I saw multiple bf counsellors, a lactation consultant, midwives. Be patient I was told. He will get the idea. Nope, I stopped trying when he was 3 months old. He had EBM until 4 months old when my supply had dwindled to virtually nothing. Anyway my point is, he wanted the comfort of sucking but couldn't/wouldn't suck my breast and would suck on a bottle, which would give him terrible colic. So we introduced a dummy for whenever he needed it. I am scrupulous about sterilising/cleaning it as mouths are teaming with bacteria. Now he often has a dummy when he goes to sleep. He doesn't have it during the day unless he's particularly teethy, where it provides comfort more than teethers until his teeth come in. I will be weaning him off it as soon as possible. So while I find your blog interesting, sometimes it seems an all or nothing approach and doesn't seem to allow for variations in parenting methods or that all babies are different. My son used to find getting undressed for skin to skin so distressing he was in a worse state, he hated being swaddled and much to my disappointment hated being in a baby carrier/sling as he couldn't wriggle freely. We have a baby led approach, guided by his needs not setting a routine, his feeding has been demand led, he is not left to cry, he was in our room until 6 months until he outgrew his crib and wasn't safe (not in bed as I was terrified of squashing him), he gets as much comfort from myself and my husband as he wants.

This could almost be our story! Had an emergency section at 32 weeks, it took a week for my milk to come in. She was very poor at sucking and despite lots of help from bfeeding nurses she never latched on properly. The hospital gave her a dummy to encourage her sucking reflex. Expressed for 4months 10 times a day and was assured my supply would increase to suit her demands- it never did because she had horrendous reflux and would throw up most of a feed then want more. I gave up exhausted, started formula and started enjoying my baby. She had a sterilized dummy every time and has weaned herself off it at 10 months. I feel they did help with her sucking, but unfortunately not quick enough for me to breastfeed.

Not suggesting anything - only that if it was a mum I was working with I would be looking to establish WHY baby can't latch, has a disorganised suck etc. What is lateral function of the tongue like, lift, protrusion? What about palate - bubbled/high arched/typical? What is baby doing with their mouth and tongue when sucking (small babies will suck a clean upturned little finger so you can feel whether they are performing appropriate action) An often missed cause can be a sneaky posterior tongue tie - the tongue can often look entirely normal to the untrained eye: http://milkmatters.org.uk/2011/04/15/hidden-cause-of-feeding-problems-however-you-feed-your-baby/

With my first, I was much the mainstream parent too. Oh, how it went against every motherly instinct! But I was constantly told it was what was best for him, so I did it. Then my second came along, and the more I read on my own, the less mainstream I became. I still tried to give both my kids pacifiers. I look back now, and am SO GLAD they didn't take to them! My second still nurses at 2.5 years old. The bond alone makes it worth all the pain, sleepless nights, and times where I feel like doing *anything but* breastfeeding (by the time they're this age, though, those moments are fewer and farther between). I was only able to nurse my first for a month. My future kids won't even have it offered to them unless there's a need (such as your preemie). Thank you for sharing this information!

What a lovely article, now we can all skip off into the sun, holding hands together. For me breastfeeding makes my skin crawl. Don't get me wrong I don't mean other people feeding their babies or infants, I mean when I do it myself. My skin prickles and the panic makes me feel like I am about to explode and turn inside out. The disgust makes me dry retch, the panic and anger builds inside me until all I can think about is flinging my precious baby just to get it away from my breasts. I have not had post natal depression by the way. I have had three children, breast feed my first for four months, second for seven and third for three and felt this way for every feed. I never flung them thank god. I feed them because everyone told me I had to, that my baby shouldn't have a bottle, that formula was chemicals and bad for them. I buckled under the pressure. Everyone made me feel like a bad mother for not wanting to feed anymore, like I was putting my own selfish desires ahead of my babies wellbeing. For me breast feeding was hell, pure hell, one I forced upon myself every single feed to satisfy all the other breastfeeding mothers out there. My beautiful children are now 9, 6 and 18 months and breastfeeding is my only horrible memory from parenting them, I have just loved the rest of it. Loved every single minute. I don't know why I felt this way. I never had any bad notions about breast feeding before this happened, never really thought about it to be honest. These memories will haunt me for the rest of my life, the helplessness, panic, disgust, anger.... all of it. For me, I think bottle feeding would have been better. Maybe think of my story next time you tell a new mother about the 'need' to breast feed.

Hi Raquel - I've supported mothers with D-Mer and it's a difficult personal journey. I don't believe I've ever told a mum she "needs" to or "must" breastfeed, it is not my role to tell any mother what to do, but to assist her to make informed choices and then support her - even if those choices are not ones I would make (it's not my journey).I wonder who is this collective group of "breastfeeding mothers" that you felt a need to satisfy? Logically a far far far bigger percentage of women are using formula than are maintaining exclusive feeding.

I think though if we're brutally honest, most of us judge ourselves much more harshly than anyone else could. If we know ultimately it's the right thing to do for our child, it can be bloody hard if that directly contradicts a need of our own (and I think bfing is just one example of this when it comes to parenting) regardless of what anyone says.

My second daughter had a dummy at less than a week old as she was using me in the same way as breast feeding. I fed her successfully for six months, but needed my sleep, and she slept very well with a dummy. What I do know is that mothers who are shattered from lack of sleep have low quality milk. I found that out with my first, who I refused to give a dummy to. I spent hours awake with her in the night which led to her being fractious and me being totally shattered. The third child I could only feed for three months due to severe mastitis. He then thrived very well on a bottle and dummy, and is now 6ft 3in! I am afraid when something like this is debated as always there are the righteous ones who think their side is right and no-one else's. Both girls are now successful parents of their own children. One breast fed successfully, and one who had to give up because despite trying her best, as an insomniac, suffered from lack of sleep. She was made to feel like a failure, which I had to assure her she wasn't. Why isn't there room for both decisions. All my grandchildren are healthy and well adjusted. I support breast feeding in public, but do not condone mothers flashing boobs around insensitively "because it is natural". I fed in public, but no-one would have known. As for the latest trick to offer vouchers for breastfeeding, where would that leave my second daughter? Feeling more of a failure and financially worse off through no fault of her own. Breast feeding is the most natural thing in the world, but not the easiest, and sometimes not the best option for the Mum. It is time we stopped judging people.

What an absolutely lovely article. Thank you for writing and addressing such an important matter. I can't even remember how many times my wife has heard that!

I have a blog in Brazil where I talk about many attachment parenting related topics, so I often translate the latest studies and researches about the benefits of breastfeeding. Would it be ok if I translated your article into Brazilian Portuguese and share it, giving you the authorship credits?

*Groans* I have to disagree with you on some of this... I mean, yes, feed on demand, absolutely, but a baby does not need the breast for EVERY need. Imagine if you were feeling frustrated or sad and you just wanted to have a big cry in someone's arms, but instead someone was trying to shove a boob in your mouth?! Imagine if you were upset and uncomfortable because you had to poo, yet someone kept sticking the boob in your mouth? I'm a huge breastfeeding advocate, I've been breastfeeding for over four years non-stop and tandem feeding for almost 2 years. I've done elimination communication with my babies and cry in arms and sometimes when a baby is upset, they are not crying to have a boob in their mouth! I baby wear all the time, and they sleep in our bed... I do it all, but I just don't believe this breastfeeding til you drop mentality. A lot of women do it this way and then they experience burn out and nursing aversion and end up weaning because that baby who got boob addicted, grows up into a boob addicted toddler and drives the mother to the point of insanity to where she feels that she has no other choice but to wean. I know the message you're trying to say, but we need to be so careful what we say because some people just cannot keep up with this breastfeed til you drop ideology...

Hmmm my thoughts are if baby doesn't want to feed, they wont - regardless of offering (and I don't know who "shoves a boob in a mouth"), with tiny babies before parents recognise different cries, I think sometimes babies don't even know what they want, but the breast meets many of those needs. When baby needs to poo, sucking relaxes the pelvic floor muscles which helps them pass things - this is why tiny babies will root frantically to suck when suffering trapped stomach wind/need to poo! Boob addiction, really? The point of the article is mothers who WANT to use their breast rather than a plastic pacifier should feel totally normal for doing so - NOT that baby is using the breast "as a pacifier".AA